COBRA & Premium Billing Admin I

Excellus BCBS•De Witt, AR

1d•$20 - $27

About The Position

The COBRA & Premium Billing Administrator responds to and resolves written, telephone, and in-person inquiries from clients and subscribers about policies and procedures. The role coordinates and monitors daily COBRA and Third-Party Premium Billing Administration activities to ensure regulatory requirements, service standards, and deadlines are met. The administrator supports client and broker operations, including responding to inquiries, preparing and delivering reports, processing member refund and payment requests, managing open enrollment requests and grace periods, reviewing payment status, managing rate renewals, and conducting software and portal demonstrations and training. The role also processes inbound and outbound membership file exchanges, coordinates carrier files for coverage reinstatements, changes, and terminations, resolves file issues with clients, brokers, vendors, and the EDI team, and supports establishing and testing new client files. At Level I, the administrator maintains knowledge of applicable regulations and plan benefits, administers group plans, researches and responds to member inquiries, processes requests that cannot be handled through the software vendor, assists with system testing and troubleshooting, and follows and helps maintain desk-level procedures. The position requires ongoing training, meeting productivity standards, protecting member privacy, and reliable attendance. Level II adds advanced research and issue resolution, support for escalated or systematic problems and client audits, service to strategic and complex accounts, and serving as a resource to team members. The role requires working at a computer workstation and using a keyboard, mouse, and/or phone for three or more hours at a time, as well as hearing, understanding, and speaking clearly on the phone, with or without a headset. Remote work may be possible on a case-by-case basis. The employer describes an inclusive workplace and offers competitive compensation and benefits; possible total-rewards components include group health and/or dental insurance, a retirement plan, wellness program, paid time away from work, and paid holidays.

Requirements

High school diploma or equivalent.
Two or more years of related experience for Level I.
General understanding of medical, dental, vision, and Medicare benefits.
Strong problem-solving, reasoning, and organizational skills, including the ability to manage multiple projects.
PC experience, including Microsoft Word and Excel.
Excellent oral and written communication skills.
Ability to communicate effectively, collaborate, and maintain positive client relationships.
Ability to work both independently and in a team environment.
For Level II, four or more years of experience working in the COBRA and Premium Billing industry.
For Level II, strong knowledge of COBRA and Premium Billing rules and regulations.
For Level II, demonstrated ability to resolve complex inquiries or escalated situations.
For Level II, advanced knowledge of the departmental software system and Excel.
Ability to sit and/or stand at a workstation while viewing a computer and using a keyboard, mouse, and/or phone for three or more hours at a time.
Ability to hear, understand, and speak clearly while using a phone, with or without a headset.

Nice To Haves

Associate degree in business administration or a related field.
Knowledge of COBRA rules and regulations.

Responsibilities

Respond to and resolve client and subscriber inquiries about policies and procedures professionally and efficiently.
Coordinate and monitor daily COBRA and Third-Party Premium Billing Administration activities to meet regulatory requirements, standards, and deadlines.
Serve as a point of contact for clients and brokers on operational matters, including inquiries, reporting, refunds, open enrollment, grace periods, member payment requests, and payment-status reviews.
Notify and educate clients about rule or regulation changes.
Conduct software and portal demonstrations and support client and broker training.
Manage rate renewals for assigned clients and participate in requested conference calls.
Process inbound and outbound departmental file exchanges, including membership additions, updates, deletions, and identified error or no-load files.
Coordinate daily carrier files for member coverage reinstatements, changes, and terminations.
Collaborate with the LBS EDI team to identify and resolve file errors.
Communicate with clients, brokers, and vendors to resolve file-processing issues.
Support establishing and testing new client files; monitor and document carrier-preferred eligibility processes.
Work with carriers to ensure billing activities meet client and carrier needs.
Maintain knowledge of COBRA and Premium Billing rules, regulations, policies, and benefits, and administer group plans in accordance with applicable requirements and service standards.
Support the customer service team by researching, interpreting, and responding to member inquiries.
Process member requests not handled through the software vendor, including payments, banking forms, enrollment forms, and termination forms.
Assist with system and release testing and troubleshooting.
Follow established desk-level procedures and participate in their development, updating, and monitoring.
Participate in ongoing training, meet productivity metrics, and complete assigned interdepartmental team tasks and standards.
Maintain knowledge of company policies and procedures, uphold the company’s code of conduct and values, protect member privacy, and maintain regular and reliable attendance.
Perform other functions as assigned by management.
At Level II, conduct advanced research and resolve inquiries and adjustments for clients, brokers, or carriers; assist with escalated or systematic issues and identify error trends.
At Level II, assist with client audits and data comparisons, service strategic and complex accounts, and serve as a resource to team members.